Reason Code 50 | Remark Code M127 - JA DME
Reason Code 50 | Remark Code M127
| Code | Description |
|---|---|
| Reason Code: 50 | These are non-covered services because this is not deemed a 'medical necessity' by the payer. |
| Remark Code: M127 | Missing patient medical record for this service. |
Common Reasons for Denial
- Documentation requested was not received or was not received timely
- Added ST or KV modifier and an affirmative UTN to claim line, which initiated a prepayment review. Documentation requested was not received
Next Step
- If the remittance advice reason includes MA130, correct claim and rebill
- A Redetermination request may be submitted with all relevant supporting documentation. Noridian encourages Redeterminations/Appeals be submitted using the Noridian Medicare Portal. Review applicable Local Coverage Determination (LCD), LCD Policy Article, and Documentation Checklists prior to submitting request. Noridian encourages Redeterminations be submitted using the Noridian Medicare Portal
How to Avoid Future Denials
- Respond to development letters with supporting documentation within designated timeline as defined on letter
- When an affirmative UTN has been received, only append the UTN, do not append the ST or KV modifier for an acute or emergent situation
Last Updated Dec 09 , 2023
